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House (Broken)
This article is a special patient case file for House's experiences in the sixth season premiere episode Broken Medical History Gregory House is a 50 year old physician. Childhood Gregory was born in 1959 to a Marine pilot and his wife and spent most of his childhood travelling to his father's duty stations, although there were periods he lived in the United States while his father was away. Although Gregory remains close to his mother, he was largely estranged from his father in adulthood. This seems to be traced to his father's treatment of him when he was younger. Although his father wasn't abusive to any great degree, he was incredibly strict and the punishments he inflicted on his son were severe. In one case he made Gregory sit in an ice bath, and in another he made Gregory sleep outside. By the age of 12, Gregory became certain that his father was not his biological father and confronted him about it in the summer of 1971. They did not speak for months after that, but still communicated by the use of written messages. It is believed that these incidents led to Gregory's generally negative attitude towards authority figures of any type. He has a history of clashing with teachers, professors, superiors and the police. Gregory suffered from the usual childhood diseases typical of an individual his age, but suffered no adverse effects or major injuries during this period. Adolescence Gregory was an outstanding student in high school, although there is evidence he took shortcuts in order to achieve high marks. This is difficult to comprehend as Gregory is extremely intelligent, knowledgeable and studious. It is believed that his cheating is a reaction to authority rather than an attempt to get ahead. He has an encyclopædic knowledge of several subjects apart from Medicine. He is an excellent musician, playing both piano and guitar. He was also an outstanding athlete, playing lacrosse at the varsity level. As he was still moving quite frequently during this period of time he had difficulty forming friendships, but did form some short-term friendships with his peers, often other musicians. He got involved with women somewhat later than his peers. However, he suffered from no major physical problems during this period. College Gregory's marks were good enough to make any choice he wished, but he decided on Johns Hopkins University for his undergraduate studies. He was not talented enough to join their lacrosse team, but participated in other sports and joined the cheer squad, primarily to meet women. He scored a perfect score on the MCAT and obtained admission to Johns Hopkins Medical School. He was one of their top students, but was expelled for cheating in his final year. Gregory has had difficulty taking responsibility for these acts, and has often blamed the incident on the student who turned him in. Despite his academic record, he finished medical school at the University of Michigan. Given his drive and intelligence, he was well known to the other students at all three schools. However, it appears during this period that Gregory started experimenting with different types of drugs. He appeared to start to prefer pharmaceuticals and engaged in a pattern of drug seeking behavior. Career Gregory's internship went very well and he was offered a choice of residencies. He eventually completed two specialties, nephrology and infectious disease. He began to be intrigued by diagnostic medicine and started taking on cases other physicians avoided, and soon made several breakthroughs, establishing a reputation for being able to solve difficult cases. He became one of the best known diagnosticians in the country, if not the world. However, his abrasive personality, poor work habits and willingness to break medical protocol enraged hospital administrators. He lost five positions in less than ten years and by his late thirties was virtually unemployable. However, he was employed by Lisa Cuddy, an old friend from UM, at Princeton-Plainsboro Teaching Hospital and has held that job for thirteen years. However, this period has not been without difficulty. He constantly challenges Dr. Cuddy's authority and although he is allowed a staff of three teaching fellows, rarely have any of them lasted for the full three years of their contract without being fired or quitting. Disability and major injury Gregory was disabled when a congenital aneurysm in his thigh clotted, causing an infarction and muscle death. It appears the treating physicians put down the leg pain to his drug abuse, allowing the clot to worsen for three days before an MRI was performed. To avoid amputation, Gregory underwent a bypass but his girlfriend at the time authorized a removal of the thigh muscle in order to prevent death from the pain of recovering from the healing process. Gregory has lost partial use of the leg, and walks with the help of cane. Because of the delay in diagnosis, he suffers from chronic pain and has developed an addiction to the narcotic drug Vicodin. Gregory was shot in the neck three years ago, but recovered after an eight week convalescence. At his own suggestion, he was given ketamine during the surgery, which temporarily alleviated his leg pain. However, the treatment wore off and Dr. House again started using Vicodin. Last year, he obtained a prescription for methadone, which also eliminated his leg pain, but he took himself off the drug due to other side effects. Recent events Gregory suffered a number of losses over the past year. First, his best friend's girlfriend died in part due to the fact that she was in a bus accident while on the vehicle with Gregory, who she had agreed to get home safely from a bar when his friend was not available. A few months later, his father died and he was able to confirm that he was not his biological father. Later that year, one of his fellows committed suicide unexpectedly. Immediately after that, Gregory started having vivid visual hallucinations of the dead girlfriend. He then suffered a delusion that Dr. Cuddy had both helped him withdraw from Vicodin and that they had slept together. He then had a hallucination of the dead fellow. As he realized he was suffering from psychosis, most likely related to his long term narcotics use, he agreed to be voluntarily committed. Other issues Gregory has formed few real relationships in his life. Apart from his mother, he has only one close friend and has only been in one real intimate relationship. He often frequents prostitutes. Gregory has a very poor opinion of psychiatrists. He has seen psychiatrists before and has dismissed them as not being able to help him. Gregory suffers from many of the symptoms of clinical depression, but has never been diagnosed with the condition. Gregory has serious trust issues. He takes the default position that everyone is lying to him, and he is not above lying himself. This is likely to seriously hamper any relationship with his treating psychiatrist. Diagnosis Antisocial personality disorder and clinical depression. Treatment protocol SSRIs, group therapy and psychotherapy Case History Gregory admitted himself as a voluntary patient. He complained that he had been suffering from vivid hallucinations of his best friend's dead girlfriend and a former fellow. He had also been suffering from delusions regarding his relationship with his hospital's Dean of Medicine. He attributed these to his addiction to the painkiller Vicodin. Gregory had gone far enough as to put himself into insulin shock in order to eliminate the hallucinations. However, staff noted that he had a long history of Vicodin use and the symptoms he complained about only occurred in the past month. Gregory most likely had serious issues apart from his Vicodin use. Despite that, Gregory was put in isolation and was given pharmacotherapy for his withdrawal symptoms and analgesics for his leg pain. Although it took several days, Gregory finally got over his withdrawal symptoms and the analgesics were helping his leg pain. He packed his clothes and asked to be released. However, Dr. Nolan had already told staff not to release him without prior permission. Gregory went to confront Dr. Nolan. Dr. Nolan agreed that Gregory could leave whenever he wanted, but advised him to stay for further treatment. He reminded Gregory that he could have detoxed anywhere, and that his symptoms were most likely not due solely to his Vicodin abuse. It was most likely a reaction to the death of his father and colleagues. When Gregory resisted, Dr. Nolan reminded him that given his current condition, he would have to advise the New Jersey medical board suspend his license and it wouldn't be reinstated until he made a recommendation in his favor. Gregory was assigned to Ward 6 and Dr. Beasley told him that his release was dependent on his cooperation with medication and therapy. However, Gregory threatened to disrupt the entire ward until Dr. Nolan wrote the recommendation letter. Gregory was assigned Alvie as a roommate. Alvie was also refusing to take medication for his bipolar disorder and it was felt that Alvie's example would convince Gregory to cooperate. Gregory immediately requested a new roommate, but was refused. Dr. Medina discussed Gregory's threat with Dr. Nolan and Dr. Beasley. He didn't believe Gregory would be disruptive because, as a physician, he would be aware that his disruption would reinforce their diagnosis. However, Dr. Nolan advised them to take the threat seriously. Gregory was introduced to the therapy group. As he promised, he was disruptive and group therapy had to be terminated. As a result, Gregory was placed in isolation. Gregory was let out to participate in physical exercise. Dr. Beasley assured him she was trying to help, but Gregory was resistant and became disruptive again. He was placed back in isolation. Dr. Beasley came back and once again asked Gregory to cooperate. Once again, he was released back to the ward and once again became disruptive, leading the rest of the patients into a revolt about the lack of paddles and net for the table tennis setup. However, Dr. Nolan soon defused the situation by bringing the patients paddles. He then told Gregory that he's a natural leader and could help the other patients. On the other hand Gregory could continue to be disruptive and see just how stubborn Dr. Nolan could be. Gregory came back to group therapy and was less disruptive, but wouldn't participate fully. When Dr. Beasley went to get him back to therapy, she told him not to scheme for a few days and let her do her job. She offered him a range of options, but he replied that he was committed to his new scheme. A day later, Gregory and Alvie got into a staged fight in the ward room. Dr. Beasley ordered haldol. It was administered to Gregory orally and he soon lapsed into unconsciousness, which was later revealed to be a ruse to get the medication to auction off to another patient. Soon, Gregory started taking his medication and participating in group therapy and exercise. However, staff noted that Gregory wasn't suffering any of the usual side effects of the medication. Staff considered that he may not be taking it. To test him, his medication was switched out to placebos. Then Dr. Medina then accused him of not taking them. Dr. House became indignant and demanded to be tested. Dr. Medina agreed and Gregory provided a urine sample. It tested positive, only because another patient hid in the bathroom stall and urinated in the cup for him. Dr. Medina lied to Gregory by apologizing for doubting him. However, when Susan was released, Gregory became indignant. He came to Dr. Nolan asking why as Susan was two privilege levels below him and had the same clinical depression scale score. Gregory agreed he still needed treatment, but wanted to proceed on an outpatient basis. Dr. Nolan refused. Gregory then revealed that he hadn't been taking his medication and that this showed he could cope and was rational. However, Dr. Nolan demonstrated that his current medication was just sugar pills and they were aware he was not on his medication. He had become suspicious when his depression scale scores improved too regularly. He told Gregory to stop fighting and to let him do his job. However, after Gregory caused a severe injury to Steve/Freedom Master by reinforcing his delusions, Dr. Nolan decided that Gregory didn't care if he ever got released or improved and told him he was being transferred. In response, Gregory asked not to be transferred because he needed help. Gregory agreed to psychotherapy but was unsure where to start. Dr. Nolan encouraged him to just talk. Gregory said he was sick of being miserable. Dr. Nolan offered him SSRIs. Gregory was resistant, but Dr. Nolan reminded him he did take medication for his pain. He realized that Gregory was afraid that he might lose whatever it was that made him a good doctor. They talked about van Gogh and Dr. Nolan assured him that if van Gogh had been treated, he still would have been a fantastic artist with two intact ears and a better life. He asked Gregory to trust him and Gregory agreed to take the medication. Dr. Nolan came by and asked Gregory about his relationships with the other patients. Dr. Nolan noticed that House had only mentioned Alvie as a person who had an opinion about him. He told Gregory that he had to talk to people about himself. He reminded Gregory that although he had relationships, he had screwed them all up. He told him he had to learn to trust people. To show him how, he took Gregory to a social event at the hospital where he didn't know anyone. Gregory spent the night convincing everyone he was either a porn star, homosexual partner of Dr. Nolan or a cheating husband. Dr. Nolan came to him and noted that none of the people he talked to had ratted him out. He could trust them. He also asked why he didn't just tell people he was a patient and if it was because he was afraid they would treat him worse. Gregory came back to therapy and told Dr. Nolan that Lydia, one of the visitors, had kissed him at the social event. Dr. Nolan reminded him that the situation was complicated, and that he realized Gregory had been thinking about the kiss ever since it happened. Gregory started deflecting and asking about Dr. Nolan's personal life. At the next therapy session, Dr. Nolan asked about Lydia again but Gregory wanted to talk abut Freedom Master. Dr. Nolan asked Gregory why he continued to dwell on his failures rather than celebrating his successes. When Gregory said that failures are forever, Dr. Nolan was positive - most people won't accept that. Failure should be acknowledged then dealt with. He suggested apologizing to Freedom Master. When Gregory suggested that wouldn't be enough, Dr. Nolan told him it would be pointless to make himself suffer as much as Freedom Master has suffered. He had to move on, apologize and make himself feel better so he could continue to feel better. Gregory went to speak to Freedom Master, but couldn't say anything. Dr. Beasley announced there would be a talent show by the patients for the staff and visitors. She hoped everyone would participate. However, Gregory became fixated on a music box in the locked room that Freedom Master was looking at. He convinced the staff to let Freecom Master have it. However, it had no effect on him. Dr. Nolan came by to remind Gregory that he was supposed to apologize, not try to fix Freedom Master. Gregory was let out on a day pass to help Dr. Nolan with his seriously ill father. However, the case was terminal and Dr. House realized that Dr. Nolan merely needed permission to pull the plug. He realized that at some point in his life, Dr. Nolan had made a mistake and lost the rest of his family. During the talent show, Alvie's rapping didn't go well and Gregory stepped in to help him out, eventually joining him on stage. Back in therapy, Gregory admitted things were getting better for him. He finally apologized to Freedom Master for putting him in a dangerous situation. However, when he took Freedom Master to Silent Girl, he handed her the music box. She thanked him and he told her she was welcome. Silent Girl was soon released. However, Gregory soon realized that the release of Silent Girl meant that Lydia was moving away to Arizona with her. Gregory asked for an overnight pass. Dr. Nolan attempted to talk him out of it, but agreed. After confronting Lydia and finding out she had a son as well as a husband, and that she was unwilling to leave them, Gregory returned to the hospital and Dr. Nolan found him outside in the parking area. Dr. Nolan was impressed that Gregory had returned to him for help rather than turning to drugs. He was also impressed that Gregory had connected with another person. He agreed to write the recommendation letter to the medical board and to release him the next day. Category:Patients Category:Mayfield Psychiatric Hospital Category:Males House (Broken) Category:Season 6